title: [Pathophysiological advances underlying the biotherapeutic revolution in inflammatory rheumatism].
abstract: Major advances have been made in the pathogenesis of rheumatoid arthritis, spondyloarthritis and connective tissue diseases, leading to new biotherapies. In rheumatoid arthritis, the discovery of anti-citrulline antibodies (ACPA, anti-citrullinatedpeptide antibodies), whose specificity is between 95% and 98% and may be present before symptom onset, allowed early diagnosis and provided new pathological insights. Studies of the role of cytokines, B cells and co-stimulation of T cells revealed novel therapeutic targets. TNF inhibitors are effective in spondyloarthritis. In lupusandSjigren'ssyndrome, genes stimulatedby IFNtypel are hyper-expressed, along with BAFF (or BLyS), a B lymphocyte-activating cytokine.
authors.affiliation: Rhumatologie, Hôpitaux universitaires Paris-Sud, AP-HP, Université Paris-Sud, INSERM U1012, Le Kremlin Bicêtre. xavier.mariette@bct.aphp.fr
authors.forename: Xavier
authors.initials: X
authors.lastname: Mariette
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D001323:Autoantibodies / Q000097:blood / Q000276:immunology; D001324:Autoantigens / Q000276:immunology / Q000378:metabolism; D001327:Autoimmune Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology; D002956:Citrulline / Q000378:metabolism; D003240:Connective Tissue Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000235:genetics / Q000276:immunology; D016207:Cytokines / Q000502:physiology; D006801:Humans; D016131:Lymphocyte Subsets / Q000276:immunology; D011499:Protein Processing, Post-Translational; D012216:Rheumatic Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000503:physiopathology*; D025241:Spondylarthritis / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000502:physiology
chemical_list: D018501:Antirheumatic Agents; D001323:Autoantibodies; D001324:Autoantigens; D016207:Cytokines; D014409:Tumor Necrosis Factor-alpha; D002956:Citrulline